The true value of protection insurance really hits home at the often emotional and traumatic time of making a claim. The speed and sensitivity with which the provider and adviser handle the claim can make a tremendous difference to the claimant and their loved ones.
As an industry, we pay out millions of pounds every week in life, critical-illness and income protection claims. Sadly, it is the minority of disputed claims that attract media and public attention.
We know the vast majority of claims are paid but there is clearly still work to be done to provide more certainty and clarity for customers. What can we do to ensure the payment of policy benefit is delivered at the time of need?
What happens at point of claim is only part of the story. By following the actions outlined below, advisers can help their clients throughout the entire advisory process from sale to claim and ensure their client is provided with comprehensive financial and emotional support service when they need it most.
AT THE POINT OF SALE Claim performance
Advisers should consider not only the appropriateness of the product features and pricing to their client’s needs but also the provider’s performance in dealing with claims. This must feature as a consideration in the advice process.
The importance of disclosure
At every stage of completing the application, advisers need to remind their clients that if they think something is relevant, they should tell their adviser and it should be included as necessary.
What is covered or not covered
The adviser should pay extra attention to explaining what is and is not covered under ill-health contracts. The Association of British Insurers’ efforts to ensure consistent critical-illness definitions and wording should help advisers and clients better understand what it is they are recommending and buying.
Pre-claim and at-claim support
Some providers offer added-value benefits to support claimants and their families.
Recent research has indicated that one of the main reasons why health protection is not more popular is the lack of confidence in a claim being paid. Providers can do more to increase the transparency of their claims record but we all know about statistics, don’t we? A common reporting format would be helpful to ensure consistency across providers and to enable comparisons to be made. Examples of paid and rejected cases would certainly help, too.
Online systems and intelligent systems-based decisions
Advances in online application systems, particularly some of the more intelligent ones, can help prompt advisers and their clients for relevant medical and risk-related information.
Telephone interviewing and underwriting
In recent years, we have witnessed advances in telephone interviewing (gathering of application information) and telephone underwriting (more in-depth collection and evaluation of medical and other risk-based information). Both these services can improve the speed and accuracy of data collection significantly. With telephone underwriting, trained medical professionals can talk directly with clients about sensitive matters, complex conditions and medication.
Proof of age
Evidence of proof of age is rarely required now at the application stage. However, it is an essential piece of evidence at point of claim. Why not submit it early on to avoid complications or delays later down the line?
POST-SALE, PRE-CLAIM Changes to health
Changes to health
The adviser must emphasise to their client the importance of informing the provider of any changes to health once the application has been submitted and before the policy commences.
More than a transaction
Too often, protection is sold in response to a specific event such as taking out a mortgage. It should form a fundamental part of a client’s longer-term financial planning strategy. Client circumstances and needs change over time and advisers should proactively review the appropriateness of protection already in place. Many plans have guaranteed insurability options that advisers and clients can take advantage of to increase or review cover when specific events occur.
Health and well-being support
Innovative and tangible extra benefits for clients are provided by some companies, for example, LV=’s Healthy Steps and Bright Grey’s Helping Hand. These can provide incentives and information to help clients manage their own health risks and enjoy a more healthy and active lifestyle.
The adviser’s role
Advisers should encourage their clients to contact them directly when they believe they have grounds to make a claim. This can help avoid spurious claims and advisers can support clients through the claims process and gathering evidence.
In our experience, the vast majority of claimants contact us directly and do not involve their adviser at all. This may be down to the sensitivity surrounding the claim or because clients feel more comfortable dealing with us direct.
Submit the claim as soon as possible
The most important thing for most claimants is to get better and return to normal life as soon as possible. Some providers, such as Pioneer and LV=, offer support to claimants and help with returning to work or alternate employment, which sometimes means that the person does not actually claim benefit.
Supply the information needed
The adviser can play an important role in helping complete claim forms and providing relevant supporting financial information. Partial information only slows down the claim process. Advisers can help to get it right first time.
The provider pays for supporting medical evidence but it is in the hands of doctors. Advisers can accelerate the process by liaising with medical practitioners directly.
Access to claims assessors
Serious and/or long-term illness can be emotional, stressful and confusing for claimants and their families. LV= offers direct access to our claims assessors so that claimants can get answers and information directly from the experts.
AFTER CLAIM More than a cheque
More than a cheque
The financial support provided by protection benefits certainly helps. To quote a recent claimant, “We all know that money does not necessarily makes things better but it sure does not make things worse.”
But there is much more that can and should be done.
The client’s needs at claim are far more than financial. The adviser can play an active role in reminding the client of the other support and services available from the provider.
These can include counselling services, information on care and recuperation services and access to additional funding. Bright Grey and LV= offer Extra Care, a service from Red Arc, and LV= also has a care and support fund available to members.